Homenaje de la Asociacion de Cardiologos de Nicaragua al Dr. Jkse Angel Montiel. Cardiologo insigne cuya actuacion clave fue decisiva para el desarrollo de una cardiologia moderna en Nicaragua
This document discusses myocardial infarction with non-obstructive coronary arteries (MINOCA). Early coronary angiography identifies an occluded vessel in most patients with STEMI but in up to 10% of AMI patients, no vessel is occluded. These patients have MINOCA. The document outlines potential causes of MINOCA including coronary artery spasm, embolism, thrombophilia, and takotsubo cardiomyopathy. It provides diagnostic criteria for different causes and recommends diagnostic tests and treatments tailored to the identified cause. The prevalence of MINOCA among all MI cases is approximately 6% but ranges from 1-14%. Prognosis varies depending on the underlying cause.
In this American Physiological Society (APS) webinar produced in partnership with ADInstruments, DeWayne Townsend, DVM, PhD and Adam Goodwill, PhD discuss how to collect and analyze quality pressure-volume loop data.
Specifically, they discuss why PV loops are considered the gold standard for measuring cardiac function in vivo, what equipment is required to collect PV loop data, and how to minimize variability in your data. The focus of the webinar is on data analysis – DeWayne and Adam demonstrate how to analyze load-independent measures of function and discuss what the data mean.
Key Learning Objectives Include:
– Why PV loops? What are the alternatives (e.g. echo, MRI, etc.) and how do PV loops compare?
– Why is the Starling effect important?
– Load independent measures: what are they and how are they measured? How are data analyzed and what do they mean?
– Equipment basics: what do you need to record PV loop data?
– What causes variability and how do you mitigate it?
Stent thrombosis is a rare but serious complication of percutaneous coronary intervention (PCI) with mortality rates between 25-40%. It is classified based on timing (acute, subacute, late, very late) and etiology (primary, secondary). Risk factors include premature discontinuation of dual antiplatelet therapy, smoking, diabetes, chronic kidney disease, acute coronary syndrome, and high platelet reactivity. Strategies to minimize stent thrombosis involve careful patient selection, optimal stent deployment, adherence to potent dual antiplatelet regimens, and treatment involving emergent thrombectomy with escalated antiplatelet therapy.
This document discusses coronary stent thrombosis, a serious complication of percutaneous coronary intervention (PCI). It outlines risk factors and prevention strategies. Key points include:
- Stent thrombosis is a nightmare for cardiologists and can have various causes, including patient factors, lesion characteristics, technical issues, and non-adherence to dual antiplatelet therapy.
- Prevention through optimal stent deployment, complete coverage of the lesion, and adherence to prolonged dual antiplatelet therapy are critical to minimizing the risk of stent thrombosis.
- Intravascular imaging can help identify issues like incomplete stent expansion or apposition that may lead to thrombosis.
- Large clinical trials have demonstrated the efficacy of newer antiplatelet regimens like
A empresa de tecnologia anunciou um novo smartphone com câmera aprimorada, processador mais rápido e bateria de maior duração. O dispositivo também possui tela maior e armazenamento expansível, com preço sugerido a partir de $799. Analistas esperam que o aparelho ajude a empresa a aumentar sua participação no competitivo mercado de smartphones.
Vericiguat is a novel oral soluble guanylate cyclase stimulator being studied for the treatment of heart failure. The VICTORIA trial investigated vericiguat for reducing cardiovascular death or heart failure hospitalization in patients with recent worsening of chronic heart failure. The trial found that vericiguat reduced the primary composite outcome compared to placebo with an absolute risk reduction of 4.2 events per 100 patient-years. Vericiguat was well-tolerated overall but increased risks of hypotension and syncope compared to placebo. The results suggest vericiguat may be an effective additional treatment for reducing heart failure hospitalizations and cardiovascular death in patients with recent heart failure decompensation.
Diabetic cardiomyopathy is characterized by ventricular dysfunction that occurs independently of coronary artery disease or hypertension. Hyperglycemia causes structural and functional damage to cardiac myocytes through increased advanced glycation end products and oxidative stress that impair calcium handling. Other risk factors include insulin resistance, dyslipidemia, hypertension, and obesity. Over time, these factors can lead to myocardial fibrosis and decreased systolic and diastolic function. Strict control of blood sugar and associated cardiovascular risk factors is important to prevent and manage diabetic cardiomyopathy.
Left ventricular non compaction is rare congenital cardiomyopathy with gaining interest due to advancement in imaging modalities for diagnosis and assessment of undulating phenotype
This document discusses myocardial infarction with non-obstructive coronary arteries (MINOCA). Early coronary angiography identifies an occluded vessel in most patients with STEMI but in up to 10% of AMI patients, no vessel is occluded. These patients have MINOCA. The document outlines potential causes of MINOCA including coronary artery spasm, embolism, thrombophilia, and takotsubo cardiomyopathy. It provides diagnostic criteria for different causes and recommends diagnostic tests and treatments tailored to the identified cause. The prevalence of MINOCA among all MI cases is approximately 6% but ranges from 1-14%. Prognosis varies depending on the underlying cause.
In this American Physiological Society (APS) webinar produced in partnership with ADInstruments, DeWayne Townsend, DVM, PhD and Adam Goodwill, PhD discuss how to collect and analyze quality pressure-volume loop data.
Specifically, they discuss why PV loops are considered the gold standard for measuring cardiac function in vivo, what equipment is required to collect PV loop data, and how to minimize variability in your data. The focus of the webinar is on data analysis – DeWayne and Adam demonstrate how to analyze load-independent measures of function and discuss what the data mean.
Key Learning Objectives Include:
– Why PV loops? What are the alternatives (e.g. echo, MRI, etc.) and how do PV loops compare?
– Why is the Starling effect important?
– Load independent measures: what are they and how are they measured? How are data analyzed and what do they mean?
– Equipment basics: what do you need to record PV loop data?
– What causes variability and how do you mitigate it?
Stent thrombosis is a rare but serious complication of percutaneous coronary intervention (PCI) with mortality rates between 25-40%. It is classified based on timing (acute, subacute, late, very late) and etiology (primary, secondary). Risk factors include premature discontinuation of dual antiplatelet therapy, smoking, diabetes, chronic kidney disease, acute coronary syndrome, and high platelet reactivity. Strategies to minimize stent thrombosis involve careful patient selection, optimal stent deployment, adherence to potent dual antiplatelet regimens, and treatment involving emergent thrombectomy with escalated antiplatelet therapy.
This document discusses coronary stent thrombosis, a serious complication of percutaneous coronary intervention (PCI). It outlines risk factors and prevention strategies. Key points include:
- Stent thrombosis is a nightmare for cardiologists and can have various causes, including patient factors, lesion characteristics, technical issues, and non-adherence to dual antiplatelet therapy.
- Prevention through optimal stent deployment, complete coverage of the lesion, and adherence to prolonged dual antiplatelet therapy are critical to minimizing the risk of stent thrombosis.
- Intravascular imaging can help identify issues like incomplete stent expansion or apposition that may lead to thrombosis.
- Large clinical trials have demonstrated the efficacy of newer antiplatelet regimens like
A empresa de tecnologia anunciou um novo smartphone com câmera aprimorada, processador mais rápido e bateria de maior duração. O dispositivo também possui tela maior e armazenamento expansível, com preço sugerido a partir de $799. Analistas esperam que o aparelho ajude a empresa a aumentar sua participação no competitivo mercado de smartphones.
Vericiguat is a novel oral soluble guanylate cyclase stimulator being studied for the treatment of heart failure. The VICTORIA trial investigated vericiguat for reducing cardiovascular death or heart failure hospitalization in patients with recent worsening of chronic heart failure. The trial found that vericiguat reduced the primary composite outcome compared to placebo with an absolute risk reduction of 4.2 events per 100 patient-years. Vericiguat was well-tolerated overall but increased risks of hypotension and syncope compared to placebo. The results suggest vericiguat may be an effective additional treatment for reducing heart failure hospitalizations and cardiovascular death in patients with recent heart failure decompensation.
Diabetic cardiomyopathy is characterized by ventricular dysfunction that occurs independently of coronary artery disease or hypertension. Hyperglycemia causes structural and functional damage to cardiac myocytes through increased advanced glycation end products and oxidative stress that impair calcium handling. Other risk factors include insulin resistance, dyslipidemia, hypertension, and obesity. Over time, these factors can lead to myocardial fibrosis and decreased systolic and diastolic function. Strict control of blood sugar and associated cardiovascular risk factors is important to prevent and manage diabetic cardiomyopathy.
Left ventricular non compaction is rare congenital cardiomyopathy with gaining interest due to advancement in imaging modalities for diagnosis and assessment of undulating phenotype
- The DAPT study was a randomized controlled trial that compared 12 versus 30 months of dual antiplatelet therapy (DAPT) consisting of aspirin and a thienopyridine after drug-eluting stent placement. Over 9,000 patients were randomized to either continue DAPT for an additional 18 months or receive a placebo. Continuing DAPT led to a significant reduction in stent thrombosis and major adverse cardiovascular events but increased the risk of moderate or severe bleeding. The study demonstrated that longer term DAPT is effective but also increases safety risks, suggesting individualized treatment based on patient risk is important.
No reflow Phenomenon Dr Hafeesh Fazulu - Pushpagiri - Jan 2021Hafeesh Fazulu
No-reflow phenomenon refers to the inability to perfuse the myocardium after opening a previously occluded coronary artery. It results from endothelial damage, platelet and fibrin embolization, vasospasm, and tissue edema overwhelming the coronary microcirculation. Risk factors include thrombus presence, cardiogenic shock, increased reperfusion time, and hyperglycemia. Diagnosis involves contrast staining in the coronary artery and residual chest pain after angioplasty. Treatment aims to prevent no-reflow through optimal blood sugar control, statin use, anticoagulation, and intracoronary nitrates. Pharmacological therapies like adenosine, statins, and calcium inhibitors may also help. Measurement of treatment outcome can be
This document discusses in-stent neoatherosclerosis, which refers to the development of new atherosclerotic lesions inside coronary stents. Percutaneous coronary intervention procedures like stenting cause endothelial injury and disrupt blood flow, promoting inflammation and accelerated atherosclerosis. Over time, this can lead to problems like in-stent restenosis and late stent thrombosis. While similar to native coronary atherosclerosis, in-stent neoatherosclerosis develops more rapidly. Factors like stent strut design, polymer coatings, and incomplete re-endothelialization all contribute to this pathological process.
The document summarizes evidence from randomized controlled trials on the use of beta blockers in patients with acute myocardial infarction (AMI). It discusses several landmark trials from the pre-reperfusion, thrombolysis, and primary PCI eras that demonstrated the benefits of early beta blocker initiation in reducing infarct size, ventricular arrhythmias, cardiogenic shock, and mortality following AMI. The COMMIT trial specifically showed that metoprolol reduces reinfarction rates, arrhythmic death, and cardiogenic shock, especially in higher risk Killip class patients.
This document discusses hybrid coronary revascularization (HCR), which combines coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI). HCR was introduced in 1996 as a treatment for multivessel coronary artery disease. It aims to reduce surgical trauma while preserving long-term survival and minimizing adverse events. The hybrid approach involves using a left internal mammary artery graft for the left anterior descending artery and PCI for other lesions. This takes advantage of the excellent outcomes of the arterial graft and improvements in stents. HCR may provide benefits for higher surgical risk patients and allow shorter recovery times compared to traditional CABG. However, some debate remains around its additional complexity and costs compared to established treatments.
Paz Argentina Quiroga: incansable luchadora por la defensa y recuperación cul...Crónicas del despojo
Nacida en tierra Warpe, provincia de San Juan, el Amta Paz Argentina Quiroga, circa ya los ochenta años y es una incansable luchadora por la defensa y recuperación cultural y espiritual del Pueblo Warpe.
- A 65-year-old female presented to the emergency room with sudden onset of chest pain, pressure, nausea, vomiting, shortness of breath, and lightheadedness.
- Her medical history included hypertension, diabetes, and hyperlipidemia. Diagnostic tests found elevated cardiac enzymes and EKG changes consistent with a heart attack.
- She was started on medications and transferred for further treatment, where imaging found apical ballooning syndrome, also known as stress-induced cardiomyopathy or "broken heart syndrome". This occurs when emotional or physical stress causes transient left ventricular dysfunction mimicking a heart attack.
Single ventricle refers to congenital heart defects where there is only one functional ventricle supporting both the pulmonary and systemic circulations. There are various classifications, and the goal of treatment is to balance blood flow between the lungs and body. Initial medical management uses prostaglandins and aims for balanced pulmonary flow. Later stages involve surgical procedures like shunts, banding of arteries, and ultimately the Fontan procedure to separate circulation to the lungs and body without overloading the single ventricle. Complications can include arrhythmias, heart failure, and protein-losing enteropathy. Long term outcomes are improved with careful patient selection and multi-stage management to optimize hemodynamics at each stage.
The SHIFT study found that treatment with ivabradine resulted in:
1) An 18% reduction in the primary composite endpoint of cardiovascular death or hospitalization for worsening heart failure compared to placebo.
2) A 26% reduction in both death from heart failure and hospitalization for heart failure.
3) Benefits were seen consistently across predefined subgroups and when added to recommended therapies, and ivabradine was generally well tolerated with low rates of treatment discontinuation due to adverse effects.
This document discusses the epidemiology and pathophysiology of heart failure. Some key points:
- Heart failure affects over 5 million Americans and prevalence is increasing as the population ages. One-year mortality is approximately 45% and survival ranges from 80% at 2 years for well-managed patients to less than 50% at 6 months for refractory cases.
- Heart failure is primarily a disease of the elderly, with 80% of hospitalized patients over 65 years old. It is the most common cause of hospitalization among Medicare patients.
- Coronary artery disease is the cause of two-thirds of left ventricular systolic dysfunction in the US. Heart failure results from structural or functional abnormalities of the heart muscle that
- Early initiation of high-intensity statin therapy in acute coronary syndrome patients significantly reduces mortality and morbidity rates compared to later initiation or lower-intensity statins. Clinical trials found a 16-36% reduction in major coronary events with early high-dose statin use.
- Guidelines recommend high-intensity statins like atorvastatin 80mg or simvastatin 80mg for acute coronary syndrome patients, though risks like side effects must be considered. Long-term statin therapy is also generally advised after acute coronary syndrome.
This document discusses biomarkers for acute heart failure syndrome (AHF). It provides definitions of AHF and notes that symptoms are primarily due to pulmonary congestion from elevated left ventricular filling pressures. Biomarkers can help with rapid assessment of hemodynamic status, guide therapy, and assess disease severity and prognosis. Examples of biomarkers discussed include B-type natriuretic peptide (BNP) and N-terminal proBNP (NT-proBNP), which reflect myocardial stress and correlate with symptoms severity. Biomarkers are also affected by cardiac and extracardiac factors. Point-of-care testing devices are being developed to rapidly measure biomarker levels to help with triage and guide therapy.
The success of neurohormonal blockade: looking back – looking forward: Beta-b...drucsamal
- The document summarizes the history of beta-blocker treatment for heart failure, from early studies in the 1970s showing potential benefits to large randomized controlled trials in the 1990s and 2000s firmly establishing mortality reduction.
- Key trials included MDC (1993) showing reduced mortality and heart transplantation, CIBIS-II (1999) showing reduced mortality with bisoprolol, MERIT-HF (1999) showing reduced mortality with metoprolol CR/XL, and COPERNICUS (2001) showing reduced mortality, hospitalizations, and worsening heart failure with carvedilol.
- Meta-analyses demonstrated a consistent mortality reduction of approximately 35% associated with beta-blocker use in
The use of extracorporeal membrane oxygenation (ECMO), and ventricular assist devices (VADs) for both short-term and long-term management of advanced cardiac (and respiratory) failure is increasing. Both thrombotic and haemorrhagic complications are common in patients receiving mechanical support, and such complications are associated with increased morbidity and mortality. Risks of bleeding and of thrombosis vary over time, and according to technical and patient factors. Careful assessment of the risks and benefits of anticoagulation for each patient is therefore a critical component of successful mechanical support.
The approach to anticoagulation for patients receiving VADs varies according to stage of recovery and device. In the immediate post-operative period, bleeding is usually a greater risk than thrombosis and a period free from anticoagulation is usually used. Subsequent initiation of anticoagulation is usually with heparin, with the introduction of warfarin and aspirin over a period of days. Current recommendations include warfarin for all continuous flow devices, usually with the addition of aspirin, and in some cases an additional antiplatelet agent. Target INR and platelet inhibition varies with device, and institution. Testing varies according to device also. Potential pitfalls and problems exist, and these will be highlighted in this session, using a case-based approach.
The management of anticoagulation for patients receiving ECMO varies worldwide, and there are currently limited guidelines. Important factors in decision-making in regards to anticoagulation for ECMO include mode of ECMO, ECMO configuration, ECMO flows, and underlying patient pathology. Strategies for anticoagulation should take each of these factors into consideration. It is also important to recognise that other management techniques to avoid thrombosis are important, such as adequate intracardiac decompression, and promoting cardiac ejection to avoid stasis. Cases will be used to demonstrate important issues and practical management strategies.
Narzędzia TOC oraz Mapy Rozwiązywania Problemów (PSM) na lekcjach matematyki - prezentacja przygotowana przez praktyków TOC - Panią Ewę Kotlik i Mariolę Wiśniewską z Elbląga. Prezentacja pokazana podczas I Kongresu TOC w Gdańsku, 06.10.17
1) El documento presenta información sobre la historia de la ateroesclerosis y los estudios clínicos que han demostrado la posibilidad de regresión de las placas de ateroma a través de modificaciones en el estilo de vida y tratamientos farmacológicos. 2) Se mencionan varios ensayos clínicos pioneros desde la década de 1960 que encontraron evidencia de regresión de la aterosclerosis mediante el uso de dieta, ejercicio y medicamentos para reducir los lípidos. 3) Los estudios más recientes utiliz
The document summarizes several primary prevention trials of statins:
1) The WOSCOPS trial found that pravastatin reduced coronary heart disease events and mortality in men aged 45-64 with moderate hypercholesterolemia.
2) The MEGA trial showed that pravastatin reduced cardiovascular events in Japanese patients with hypercholesterolemia and lower baseline risks compared to Western trials.
3) The AFCAPS/TexCAPS trial found that lovastatin reduced first acute major coronary events in patients without clinically evident cardiovascular disease but with average cholesterol levels.
http://www.theheart.org/web_slides/1416535.do
A trial to compare Fractional Flow Reserve versus Angiography for Guiding PCI in Patients with Multivessel Coronary Artery Disease II
This document provides an overview of in-stent restenosis. It defines in-stent restenosis as the narrowing of a vessel segment at the site of a previously placed stent due to neointimal proliferation. The incidence of in-stent restenosis ranges from 3-20% with drug-eluting stents and 16-44% with bare-metal stents. Predictors of in-stent restenosis include patient characteristics like diabetes, lesion characteristics like length and diameter, and procedural characteristics like incomplete stent expansion. The document discusses the etiology, clinical presentation, assessment, and treatment options for in-stent restenosis.
El documento resume la historia de la angiografía coronaria y la angioplastia desde sus orígenes hasta la actualidad. Comienza describiendo los primeros informes de angina de pecho en el siglo XIX y avances en la comprensión de su etiología. Luego detalla hitos clave como el primer uso de cateteres en 1929, el desarrollo de la angiografía coronaria en la década de 1950 y la primera angioplastia con balón exitosa en 1977. Finalmente, resume avances posteriores como las técnicas de stenting y ultrasonido intra
- The DAPT study was a randomized controlled trial that compared 12 versus 30 months of dual antiplatelet therapy (DAPT) consisting of aspirin and a thienopyridine after drug-eluting stent placement. Over 9,000 patients were randomized to either continue DAPT for an additional 18 months or receive a placebo. Continuing DAPT led to a significant reduction in stent thrombosis and major adverse cardiovascular events but increased the risk of moderate or severe bleeding. The study demonstrated that longer term DAPT is effective but also increases safety risks, suggesting individualized treatment based on patient risk is important.
No reflow Phenomenon Dr Hafeesh Fazulu - Pushpagiri - Jan 2021Hafeesh Fazulu
No-reflow phenomenon refers to the inability to perfuse the myocardium after opening a previously occluded coronary artery. It results from endothelial damage, platelet and fibrin embolization, vasospasm, and tissue edema overwhelming the coronary microcirculation. Risk factors include thrombus presence, cardiogenic shock, increased reperfusion time, and hyperglycemia. Diagnosis involves contrast staining in the coronary artery and residual chest pain after angioplasty. Treatment aims to prevent no-reflow through optimal blood sugar control, statin use, anticoagulation, and intracoronary nitrates. Pharmacological therapies like adenosine, statins, and calcium inhibitors may also help. Measurement of treatment outcome can be
This document discusses in-stent neoatherosclerosis, which refers to the development of new atherosclerotic lesions inside coronary stents. Percutaneous coronary intervention procedures like stenting cause endothelial injury and disrupt blood flow, promoting inflammation and accelerated atherosclerosis. Over time, this can lead to problems like in-stent restenosis and late stent thrombosis. While similar to native coronary atherosclerosis, in-stent neoatherosclerosis develops more rapidly. Factors like stent strut design, polymer coatings, and incomplete re-endothelialization all contribute to this pathological process.
The document summarizes evidence from randomized controlled trials on the use of beta blockers in patients with acute myocardial infarction (AMI). It discusses several landmark trials from the pre-reperfusion, thrombolysis, and primary PCI eras that demonstrated the benefits of early beta blocker initiation in reducing infarct size, ventricular arrhythmias, cardiogenic shock, and mortality following AMI. The COMMIT trial specifically showed that metoprolol reduces reinfarction rates, arrhythmic death, and cardiogenic shock, especially in higher risk Killip class patients.
This document discusses hybrid coronary revascularization (HCR), which combines coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI). HCR was introduced in 1996 as a treatment for multivessel coronary artery disease. It aims to reduce surgical trauma while preserving long-term survival and minimizing adverse events. The hybrid approach involves using a left internal mammary artery graft for the left anterior descending artery and PCI for other lesions. This takes advantage of the excellent outcomes of the arterial graft and improvements in stents. HCR may provide benefits for higher surgical risk patients and allow shorter recovery times compared to traditional CABG. However, some debate remains around its additional complexity and costs compared to established treatments.
Paz Argentina Quiroga: incansable luchadora por la defensa y recuperación cul...Crónicas del despojo
Nacida en tierra Warpe, provincia de San Juan, el Amta Paz Argentina Quiroga, circa ya los ochenta años y es una incansable luchadora por la defensa y recuperación cultural y espiritual del Pueblo Warpe.
- A 65-year-old female presented to the emergency room with sudden onset of chest pain, pressure, nausea, vomiting, shortness of breath, and lightheadedness.
- Her medical history included hypertension, diabetes, and hyperlipidemia. Diagnostic tests found elevated cardiac enzymes and EKG changes consistent with a heart attack.
- She was started on medications and transferred for further treatment, where imaging found apical ballooning syndrome, also known as stress-induced cardiomyopathy or "broken heart syndrome". This occurs when emotional or physical stress causes transient left ventricular dysfunction mimicking a heart attack.
Single ventricle refers to congenital heart defects where there is only one functional ventricle supporting both the pulmonary and systemic circulations. There are various classifications, and the goal of treatment is to balance blood flow between the lungs and body. Initial medical management uses prostaglandins and aims for balanced pulmonary flow. Later stages involve surgical procedures like shunts, banding of arteries, and ultimately the Fontan procedure to separate circulation to the lungs and body without overloading the single ventricle. Complications can include arrhythmias, heart failure, and protein-losing enteropathy. Long term outcomes are improved with careful patient selection and multi-stage management to optimize hemodynamics at each stage.
The SHIFT study found that treatment with ivabradine resulted in:
1) An 18% reduction in the primary composite endpoint of cardiovascular death or hospitalization for worsening heart failure compared to placebo.
2) A 26% reduction in both death from heart failure and hospitalization for heart failure.
3) Benefits were seen consistently across predefined subgroups and when added to recommended therapies, and ivabradine was generally well tolerated with low rates of treatment discontinuation due to adverse effects.
This document discusses the epidemiology and pathophysiology of heart failure. Some key points:
- Heart failure affects over 5 million Americans and prevalence is increasing as the population ages. One-year mortality is approximately 45% and survival ranges from 80% at 2 years for well-managed patients to less than 50% at 6 months for refractory cases.
- Heart failure is primarily a disease of the elderly, with 80% of hospitalized patients over 65 years old. It is the most common cause of hospitalization among Medicare patients.
- Coronary artery disease is the cause of two-thirds of left ventricular systolic dysfunction in the US. Heart failure results from structural or functional abnormalities of the heart muscle that
- Early initiation of high-intensity statin therapy in acute coronary syndrome patients significantly reduces mortality and morbidity rates compared to later initiation or lower-intensity statins. Clinical trials found a 16-36% reduction in major coronary events with early high-dose statin use.
- Guidelines recommend high-intensity statins like atorvastatin 80mg or simvastatin 80mg for acute coronary syndrome patients, though risks like side effects must be considered. Long-term statin therapy is also generally advised after acute coronary syndrome.
This document discusses biomarkers for acute heart failure syndrome (AHF). It provides definitions of AHF and notes that symptoms are primarily due to pulmonary congestion from elevated left ventricular filling pressures. Biomarkers can help with rapid assessment of hemodynamic status, guide therapy, and assess disease severity and prognosis. Examples of biomarkers discussed include B-type natriuretic peptide (BNP) and N-terminal proBNP (NT-proBNP), which reflect myocardial stress and correlate with symptoms severity. Biomarkers are also affected by cardiac and extracardiac factors. Point-of-care testing devices are being developed to rapidly measure biomarker levels to help with triage and guide therapy.
The success of neurohormonal blockade: looking back – looking forward: Beta-b...drucsamal
- The document summarizes the history of beta-blocker treatment for heart failure, from early studies in the 1970s showing potential benefits to large randomized controlled trials in the 1990s and 2000s firmly establishing mortality reduction.
- Key trials included MDC (1993) showing reduced mortality and heart transplantation, CIBIS-II (1999) showing reduced mortality with bisoprolol, MERIT-HF (1999) showing reduced mortality with metoprolol CR/XL, and COPERNICUS (2001) showing reduced mortality, hospitalizations, and worsening heart failure with carvedilol.
- Meta-analyses demonstrated a consistent mortality reduction of approximately 35% associated with beta-blocker use in
The use of extracorporeal membrane oxygenation (ECMO), and ventricular assist devices (VADs) for both short-term and long-term management of advanced cardiac (and respiratory) failure is increasing. Both thrombotic and haemorrhagic complications are common in patients receiving mechanical support, and such complications are associated with increased morbidity and mortality. Risks of bleeding and of thrombosis vary over time, and according to technical and patient factors. Careful assessment of the risks and benefits of anticoagulation for each patient is therefore a critical component of successful mechanical support.
The approach to anticoagulation for patients receiving VADs varies according to stage of recovery and device. In the immediate post-operative period, bleeding is usually a greater risk than thrombosis and a period free from anticoagulation is usually used. Subsequent initiation of anticoagulation is usually with heparin, with the introduction of warfarin and aspirin over a period of days. Current recommendations include warfarin for all continuous flow devices, usually with the addition of aspirin, and in some cases an additional antiplatelet agent. Target INR and platelet inhibition varies with device, and institution. Testing varies according to device also. Potential pitfalls and problems exist, and these will be highlighted in this session, using a case-based approach.
The management of anticoagulation for patients receiving ECMO varies worldwide, and there are currently limited guidelines. Important factors in decision-making in regards to anticoagulation for ECMO include mode of ECMO, ECMO configuration, ECMO flows, and underlying patient pathology. Strategies for anticoagulation should take each of these factors into consideration. It is also important to recognise that other management techniques to avoid thrombosis are important, such as adequate intracardiac decompression, and promoting cardiac ejection to avoid stasis. Cases will be used to demonstrate important issues and practical management strategies.
Narzędzia TOC oraz Mapy Rozwiązywania Problemów (PSM) na lekcjach matematyki - prezentacja przygotowana przez praktyków TOC - Panią Ewę Kotlik i Mariolę Wiśniewską z Elbląga. Prezentacja pokazana podczas I Kongresu TOC w Gdańsku, 06.10.17
1) El documento presenta información sobre la historia de la ateroesclerosis y los estudios clínicos que han demostrado la posibilidad de regresión de las placas de ateroma a través de modificaciones en el estilo de vida y tratamientos farmacológicos. 2) Se mencionan varios ensayos clínicos pioneros desde la década de 1960 que encontraron evidencia de regresión de la aterosclerosis mediante el uso de dieta, ejercicio y medicamentos para reducir los lípidos. 3) Los estudios más recientes utiliz
The document summarizes several primary prevention trials of statins:
1) The WOSCOPS trial found that pravastatin reduced coronary heart disease events and mortality in men aged 45-64 with moderate hypercholesterolemia.
2) The MEGA trial showed that pravastatin reduced cardiovascular events in Japanese patients with hypercholesterolemia and lower baseline risks compared to Western trials.
3) The AFCAPS/TexCAPS trial found that lovastatin reduced first acute major coronary events in patients without clinically evident cardiovascular disease but with average cholesterol levels.
http://www.theheart.org/web_slides/1416535.do
A trial to compare Fractional Flow Reserve versus Angiography for Guiding PCI in Patients with Multivessel Coronary Artery Disease II
This document provides an overview of in-stent restenosis. It defines in-stent restenosis as the narrowing of a vessel segment at the site of a previously placed stent due to neointimal proliferation. The incidence of in-stent restenosis ranges from 3-20% with drug-eluting stents and 16-44% with bare-metal stents. Predictors of in-stent restenosis include patient characteristics like diabetes, lesion characteristics like length and diameter, and procedural characteristics like incomplete stent expansion. The document discusses the etiology, clinical presentation, assessment, and treatment options for in-stent restenosis.
El documento resume la historia de la angiografía coronaria y la angioplastia desde sus orígenes hasta la actualidad. Comienza describiendo los primeros informes de angina de pecho en el siglo XIX y avances en la comprensión de su etiología. Luego detalla hitos clave como el primer uso de cateteres en 1929, el desarrollo de la angiografía coronaria en la década de 1950 y la primera angioplastia con balón exitosa en 1977. Finalmente, resume avances posteriores como las técnicas de stenting y ultrasonido intra
Este documento resume las principales aplicaciones de las imágenes en cardiología. Describe brevemente la historia de la cardiología intervencionista y la angiografía. Explica el uso de técnicas como la angiografía, ecocardiografía, TAC coronaria y resonancia magnética en el diagnóstico y tratamiento de enfermedades cardiovasculares como la enfermedad coronaria y valvular. También cubre procedimientos como la angioplastia, colocación de stents, valvuloplastias y el cierre de defectos cardíacos.
La historia de la cardiología intervencionista comenzó con el uso de tubos de bronce en Mesopotamia y el antiguo Egipto. En el siglo XX, se desarrollaron técnicas como la angiografía, la cateterización cardiaca y la angioplastia con balón. En 1977, Andreas Gruentzig realizó la primera angioplastia coronaria exitosa con balón, marcando el inicio de la cardiología intervencionista moderna. Desde entonces, se han introducido numerosos dispositivos como los stents que han revolucionado el tratamiento de
Este documento resume la enfermedad carotídea. Entre el 15-20% de los pacientes con AIT o ACV isquémico tienen estenosis significativa en la bifurcación de la carótida ipsilateral. La cirugía carotídea reduce significativamente el riesgo de eventos cerebrovasculares en pacientes con estenosis carotídea sintomática del 70% al 99%, pero solo ofrece beneficios parciales en aquellos con estenosis del 50% al 69%. El tratamiento médico es superior a la cirugía para estenosis menores al 50%.
Puesta al dia en cardiologia intervencionista - Curso ADNadnmedicina
Este documento presenta un resumen histórico del intervencionismo cardiaco. Comienza describiendo los primeros avances en la introducción de catéteres en 1844. Luego resume hitos clave como la primera angiografía coronaria en 1958 y la primera angioplastia en 1964. Finalmente, menciona el desarrollo de los primeros stents balón expandibles en 1989. El documento ofrece una breve reseña de los principales avances en la especialidad.
El documento resume la historia de la cirugía, desde los primeros conocimientos de anatomía en la antigüedad hasta los avances modernos. Destaca hitos como el control de la hemorragia por Ambroise Paré en el siglo XVI, el descubrimiento de la anestesia por Morton en 1846, y el control de la infección por Lister en el siglo XIX. También describe avances posteriores como la transfusión de sangre, los rayos X, y el desarrollo de la cirugía científica en el siglo XX.
Este documento clasifica y define las malformaciones arteriovenosas y describe su epidemiología, cuadro clínico, diagnóstico y tratamientos. Las malformaciones arteriovenosas son lesiones vasculares congénitas que comunican arterias y venas sin lecho capilar intermedio. Pueden causar hemorragia cerebral o convulsiones. Su tratamiento incluye cirugía microquirúrgica, terapia endovascular, radiocirugía o radioterapia, dependiendo del tamaño y ubicación de la malformación.
Linea del tiempo historia de la cirugia cardiovascularEstebanTavera1
Este documento presenta una línea de tiempo histórica de la cirugía cardiovascular desde 1812 hasta 1982. Algunos hitos importantes incluyen la primera sutura de una herida por arma blanca en 1885, la primera ligadura del ductus arterioso en 1924, y el primer trasplante de corazón exitoso en 1967. Michael De Bakey es considerado el "padre de la cirugía cardiovascular" por sus innovaciones pioneras como el desarrollo de la bomba de rodillos en la década de 1920.
Relato de la historia de cirugia en la era antigua, conocimiento de anatomía, control de dolor, control de infección, control de hemorragias, diversidad en medicina vista hacia el futuro de la cirugía.
Síndrome Aórtico Agudo - Dr. Marcelo HalacMarcelo Halac
XXIX Jornadas SOLACI - XI Jornada de la Región Centroamérica y Caribe - XXIII Simposio Internacional - XI Taller Nacional de Cardiología Intervencionista - VII Jornada Programa SOL SOLACI
Este documento presenta un manual sobre tomografía axial computarizada multicorte (TACM). Explica brevemente la historia de la TAC desde su descubrimiento en 1972 hasta los avances más recientes en equipos de 64 cortes. También resume los principios básicos de la TACM y ofrece un índice de los diferentes capítulos que cubren el estudio de vasos arteriales específicos y órganos usando esta técnica.
Alexis Carrel, premio Nobel de Medicina y Fisiología en 1912.
Pionero de la Cirugía vascular y de los Trasplantes.
El gran humanista de "La incógnita del hombre"
Este documento describe la historia y evolución de la donación y trasplante de órganos desde sus inicios experimentales hasta los logros actuales. Comienza relatando los primeros intentos de trasplante renal en la década de 1930 y el primer trasplante renal exitoso entre gemelos idénticos en 1954. Luego explica los avances en trasplante hepático y cardíaco en la década de 1960, incluido el primer trasplante de corazón exitoso realizado por Christiaan Barnard en 1967. Finalmente, resume la evolución del
El documento resume brevemente la historia de la anestesia desde la antigüedad hasta la actualidad. En la antigua Grecia y China se utilizaban sustancias como el opio y el humo de marihuana para inducir anestesia. En 1846, William Morton utilizó éter como el primer anestésico químico, y en 1847 John Snow publicó sobre la inhalación de éter. En la segunda mitad del siglo XIX se desarrollaron nuevos anestésicos como el cloroformo y la lidocaína. En el siglo XX se sintet
Este documento presenta información sobre varios cirujanos galardonados con el Premio Nobel en Medicina, incluyendo sus países de origen, años de premio y contribuciones principales. También describe la técnica de triangulación de Carrel desarrollada por el cirujano francés Alexis Carrel para suturar vasos sanguíneos de manera efectiva.
Christiaan Barnard fue un cirujano sudafricano recordado por realizar el primer trasplante de corazón con éxito en 1967. Estudió en Estados Unidos y se especializó en cirugía cardiovascular. Dirigió el hospital Groote Schuur en Ciudad del Cabo donde llevó a cabo el primer trasplante de corazón entre Louis Washkansky y Denise Darvall, aunque el paciente falleció 18 días después. Continuó realizando trasplantes y avanzando el campo, pero sus experimentos terminaron en fracaso.
Similar a Homenaje al Dr. Jose Angel Montiel. Cardiologo de Nicaragua (20)
1. The document discusses several cardiovascular complications that can arise from COVID-19 infection, including myocarditis, arrhythmias, acute coronary syndromes, and heart failure.
2. Specific topics covered include COVID-19 related myocarditis, the potential for the virus to directly infect the myocardium, the increased risk of arrhythmias due to systemic inflammation, and post-COVID cardiovascular conditions.
3. Research is ongoing regarding the long term cardiovascular effects of COVID-19 and the immunological mechanisms involved.
EVALUACION DEL RISGO CARDIOVASCULAR EN DIABETICOSDaniel Meneses
Este documento resume las principales ideas sobre la evaluación del riesgo cardiovascular en pacientes diabéticos. En primer lugar, destaca que la diabetes no es equivalente a enfermedad cardiovascular y que existe gran heterogeneidad en el riesgo entre pacientes diabéticos. En segundo lugar, señala que el juicio clínico solo es insuficiente para estimar el riesgo individual, por lo que se debe usar calculadoras de riesgo validadas. Finalmente, resalta la importancia de evaluar específicamente el riesgo de insuficiencia cardíaca en mujeres diabé
TRATAMIENTO DE INSUFICIENCIA CARDIACA EN 2020Daniel Meneses
El objetivo del tratamiento de este paciente sería reducir el desbalance neurohormonal. La terapia farmacológica ideal sería sacubitril/valsartán combinado con beta bloqueantes, antagonistas de los receptores de mineralcorticoides e inhibidores de SGLT2, dado el efecto sinérgico demostrado entre estas clases de medicamentos. Se deberían considerar también medidas adicionales de diagnóstico y tratamiento como optimización de dosis y adherencia a la medicación.
Venas; el lado oculto de la cardiologia intervencionistaDaniel Meneses
Este documento discute varias condiciones venosas como la trombosis venosa profunda, la tromboembolia pulmonar, la insuficiencia venosa, las varices y las ulceras venosas. También cubre procedimientos intervencionistas como filtros de vena cava e intervenciones percutáneas en venas para tratar estas afecciones venosas.
La actualización en TAVI 2019 presentada por el Dr. Daniel Meneses destaca los siguientes puntos clave: 1) La técnica TAVI (implante de válvula aórtica transcatéter) ha evolucionado rápidamente en los últimos años y ahora se considera un tratamiento estándar para el estrechamiento de la válvula aórtica en pacientes de alto riesgo quirúrgico. 2) Se han desarrollado nuevas válvulas que son más pequeñas y fáciles de implantar, mejorando los resultados para los pacientes. 3
Insuficiencia cardíaca. como bajar la mortalidad en el 2019Daniel Meneses
El documento describe el caso de un paciente de 69 años con insuficiencia cardíaca e historia de infarto de miocardio, diabetes e hipertensión. El paciente presentaba disnea, edemas y otros síntomas de descompensación a pesar de recibir un tratamiento escalonado que incluía betabloqueantes, diuréticos, antagonistas de aldosterona y otros fármacos. El documento sugiere que el tratamiento de la insuficiencia cardíaca debe realizarse de forma escalonada mediante la adición progresiva de inhibidores de
This document provides guidelines for the management of cholesterol. It was written by a committee of experts and provides recommendations based on levels of evidence. It discusses recommendations for patients at very high risk of cardiovascular events, those with diabetes, severe hypercholesterolemia, and other risk factors. It also addresses treatment strategies, including lifestyle changes and medication management, for various patient populations aiming to reduce cardiovascular risk.
Catalogo de jabones natural cosmetica de nicaraguaDaniel Meneses
El documento presenta una lista de diferentes jabones naturales, incluyendo jabones de leche de cabra, noni, moringa, bebé, cúrcuma, chocolate, café, guanábana, íntimo femenino, mamapina, sábila y sal, mango, carbón activado, nopal, de castilla y para mascotas. Cada entrada describe brevemente los beneficios e ingredientes del jabón correspondiente.
PROPIEDADES COSMETICAS DEL ACEITE DE COCO, COMO USARLO COMO MASCARILLA FACIAL, COMO ACEITE DESMAQUILLANTE, COMO FIJADOR DEL CABELLO, COMO ACEITE RELAJANTE, COMO ACEITE PARA ALREDEDOR DE LOS OJOS
que es un jabón natural, que diferencia hay con los jabones comerciales, como cuidarlos, ejemplos de jabones naturales de gran calidad, natural cosmética de Nicaragua
Seleccionando estrategias exitosas en la cie dr josé daniel meneses mercado...Daniel Meneses
Este documento discute estrategias para el tratamiento de la cardiopatía isquémica estable. Presenta las guías actuales que recomiendan identificar tempranamente los factores de riesgo cardiovascular e intervenir con medicamentos como aspirina, estatinas e IECAs/ARA II. También recomiendan tratar de manera eficaz y segura a los pacientes con cardiopatía isquémica diagnosticada, utilizando opciones como la ranolazina que ofrece beneficios antianginosos y metabólicos sin afectar la presión arterial ni la
La paciente es una mujer de 50 años con diabetes tipo 2 de 5 años de evolución y buen control metabólico, así como hipertensión leve y obesidad grado I. Presenta un cuadro clínico de angina de pecho típica de reciente inicio. Los exámenes físicos y complementarios como electrocardiograma de reposo son normales.
El documento habla sobre el retiro de un introductor femoral después de un cateterismo. Describe que un paciente de 39 años masculino que fuma sufrió un infarto agudo de miocardio con elevación del segmento ST en la cara inferior y se le colocó un stent resolute de 3.5/30 mm. Recomienda usar guía ultrasónica para la punción femoral y compresión manual como método estándar para cerrar el acceso vascular después del procedimiento.
El documento presenta los protocolos de manejo de síndromes coronarios agudos y angina estable del Dr. Daniel Meneses. Incluye información sobre diagnóstico, estratificación de riesgo, antiagregación, anticoagulación y tratamientos como ICP vs fibrinólisis. También cubre el manejo de angina estable y contiene gráficos y tablas sobre dolor precordial, electrocardiogramas, marcadores cardiacos y complicaciones renales.
Este documento discute la relación entre la inflamación y las enfermedades cardiovasculares. La inflamación juega un papel importante en el desarrollo de la enfermedad arterial coronaria y otras complicaciones de la aterosclerosis. Los marcadores inflamatorios como la proteína C reactiva de alta sensibilidad se asocian con un mayor riesgo de eventos cardiovasculares. El sistema renina-angiotensina-aldosterona contribuye a la inflamación vascular. El bloqueo del receptor de angiotensina reduce la inflamación y prev
Sesión realizada por una EIR de Pediatría sobre aspectos clave de la valoración nutricional del paciente pediátrico en Oncología, y con tres mensajes para llevarse a casa:
- La evaluación del riesgo y la planificación del soporte nutricional deben formar parte de la planificación terapéutica global del paciente oncológico desde el principio.
- Existe suficiente evidencia científica de que una intervención nutricional adecuada es capaz de prevenir las complicaciones de la malnutrición, mejorar la calidad de vida como la tolerancia y respuesta al tratamiento y acortar la estancia hospitalaria.
- En los hospitales hay pocos dietistas que trabajen exclusivamente en la unidad de Oncología Pediátrica, y esto puede repercutir en mayores gastos sanitarios, peor estado general de los pacientes y menor supervivencia.
En esta presentación encontrarán información detallada sobre cómo realizar correctamente la maniobra de Heimlich y también información sobre lo que es la asfixia.
TRIAGE EN DESASTRES Y SU APLICACIÓN.pptxsaraacuna1
Se habla sobre el Triage, sus tipos y cómo aplicarlo en algún desastre. Además de explicar los pasos de los triages más usados como el SHORT y el START.
SEMIOLOGIA MEDICA - Escuela deMedicina Dr Witremundo Torrealba 2024Carmelo Gallardo
Escuela de Medicina Dr Witremundo Torrealba
.
Primer Lapso de Semiología
.
Conceptos de Semiología Médica, Signos, Síntomas, Síndromes, Diagnóstico, Pronóstico
Fijación, transporte en camilla e inmovilización de columna cervical II.pptxmichelletsuji1205
Ante una lesión de columna cervical es vital saber como debemos proceder, por lo que este informe detalla los procedimientos y precauciones necesarios para la adecuada inmovilización de la misma, destacando su relevancia debido a la frecuencia de lesiones asociadas, así como los materiales requeridos y el momento oportuno para llevar a cabo esta práctica en la atención inicial a pacientes politraumatizados. El objetivo es asegurar la máxima supervivencia del paciente hasta su traslado al hospital."
Eleva tu rendimiento mental tomando RiseThe Movement
¡Experimenta una Mayor Concentración, Claridad y Energía con RISE! 🌟
¿Te cuesta mantener la concentración, la claridad mental y la energía durante todo el día?
La falta de concentración y claridad puede afectar tu rendimiento mental, creatividad y motivación, haciéndote sentir agotado y sin ánimo. Las soluciones tradicionales pueden ser ineficaces y a menudo vienen con efectos secundarios no deseados. ¿No sería genial tener una solución natural que funcione rápidamente y sin efectos secundarios negativos?
¡Descubre nuestra mezcla de bebidas nootrópicas RISE! Formulada con 7 hongos orgánicos, vitaminas B metiladas y aminoácidos, esta potente mezcla trabaja rápidamente para estimular tu cerebro y estabilizar tu mente.
Beneficios de RISE:
Desempeño mental: Mejora tu capacidad cognitiva y rendimiento.
Salud mental: Apoya el bienestar mental y reduce el estrés.
Claridad mental: Aumenta tu enfoque y claridad.
Energía: Proporciona energía sostenida sin picos y caídas.
Creatividad y motivación: Estimula tu creatividad y te mantiene motivado.
Concentración: Mejora tu capacidad de concentración.
Alerta: Mantente alerta y despierto durante todo el día.
Ánimo: Mejora tu estado de ánimo y bienestar general.
Respuesta antiinflamatoria: Reduce la inflamación y promueve una salud óptima.
viene en un delicioso sabor a limonada de mango, haciendo de esta bebida no solo un potente estimulante cerebral, sino también un manjar saludable y delicioso para tu cuerpo y mente.
¡Siéntete mejor ya y experimenta por ti mismo! Esta limonada de mango te volará la mente. 🤯
Está diseñada para atraer a personas que buscan mejorar su concentración, claridad mental y energía de manera rápida y efectiva, utilizando una mezcla de ingredientes naturales y nootrópicos.
Terapia cinematográfica (6) Películas para entender los trastornos del neurod...JavierGonzalezdeDios
Los trastornos del neurodesarrollo comprenden un grupo heterogéneo de trastornos crónicos que se manifiestan en períodos tempranos de la niñez y que, en conjunto, comparten una alteración en la adquisición de habilidades cognitivas, motoras, del lenguaje y/o sociales que impactan significativamente en el funcionamiento personal, social y académico. Tienen su origen en la primera infancia o durante el proceso de desarrollo y comprende a heterogéneos procesos englobados bajo esta etiqueta.
El Manual diagnóstico y estadístico de los trastornos mentales en su quinta edición (DSM-V) incluye dentro los trastornos del neurodesarrollo los siguientes siete grupos: Discapacidad intelectual, Trastornos de la comunicación, Trastorno del espectro del autismo (TEA), Trastorno de atención con hiperactividad (TDAH), Trastornos específico del aprendizaje, Trastornos motores y Trastornos de tics. Es importante tener en cuenta que en una misma persona puede manifestarse más de un trastorno del neurodesarrollo. Y, dentro de todos los trastornos del neurodesarrollo, el autismo adquiere una especial importancia, por lo que será considerado en el próximo capítulo de la serie “Terapia cinematográfica” de forma particular.
Y esta gran diversidad también la ha reflejado en la gran pantalla y en las historias “de cine” que el séptimo arte nos ha regalado. Y hoy proponemos un recordatorio de la amplia variedad y complejidad de los trastornos del neurodesarrollo en la infancia a través de 7 películas argumentales. Estas películas son, por orden cronológico de estreno:
- El milagro de Ana Sullivan (The Miracle Worker, Arthur Penn, 1962) 6, para valorar el milagro de la palabra, el milagro del lenguaje y de los sentidos.
- Forrest Gump (Robert Zemeckis, 1994) 7, para comprender el valor de la lucha por encontrar cuál es la meta de cada uno, una mezcla de destino y sueños propios.
- Estrellas en la Tierra (Taare Zameen Par, Aamir Khan, 2007) 8, para confirmar que cada niño y niña es especial, incluso con sus potenciales deficiencias psíquicas, físicas y/o sensoriales.
- El primero de la clase (Front of the Class, Peter Werner, 2008) 9, para demostrar el valor de la superación y como, a pesar de nuestras dificultades, somos merecedores de oportunidades.
- Cromosoma 5 (María Ripoll, 2013) 10, para entender la soledad del corredor de fondo ante los trastornos del neurodesarrollo.
- Gabrielle (Louise Archambault, 2013) 11, para intentar normalizar las relaciones afectivas y amorosas entre dos personas con enfermedades mentales y discapacidad.
- Línea de meta (Paola García Costas, 2014) 12, para interiorizar que la carrera de la vida es especialmente difícil para algunos.
Siete películas argumentales que el séptimo arte nos presenta con protagonistas afectos con diferentes trastornos del neurodesarrollo durante su infancia, adolescencia y juventud y que nos ayudan a comprender que cada persona es especial, diversa y con capacidades diferenciales que hay que respetar y potenciar.
Terapia cinematográfica (6) Películas para entender los trastornos del neurod...
Homenaje al Dr. Jose Angel Montiel. Cardiologo de Nicaragua
1. Dr. Daniel Meneses M
PRESIDENTE
ASOCIACION DE CARDIOLOGOS DE NICARAGUA
IX CONGRESO NACIONA DEL CARDIOLOGIA
LECTURA INAGURAL 2011
“Dr. José Ángel Montiel”
7. Dres. Ivan Tercero Talavera y Juan Darce.Dres. Ivan Tercero Talavera y Juan Darce.
8. HISTORIA DE LA CARDIOLOGIA
NICARAGUENSE
• PERIODO DE ORO DE
LA CIRUGIA CARDIACA
(1955-1968).
• PERIODO DE
DESASTRES (1968-
1996)
• PERIODO DE ORO DEL
CATETERISMO
CARDIACO (1996-
ACTUAL)
9. HISTORIA DE LA CARDIOLOGIA
NICARAGUENSE
• PERIODO DE ORO DE
LA CIRUGIA
CARDIACA (1955-
1968).
10. 1952 F. John Lewis, un Cirujano Americano realiza la primer
cirugia de corazon abierto exitosa .
11. 1953 John H. Gibbon, un Cirujano Americano , utiliza la primer
Bomba de Circulacion Extracorporea
12. BREVE HISTORIA DE LA CARDIOLOGIA EN NICARAGUA
• PERIODO DE ORO DE LA CIRUGIA
CARDIACA (1955-1968)
HOSPITAL EL RETIRO 1962-1972
1000 CAMAS
13. BREVE HISTORIA DE LA CARDIOLOGIA EN NICARAGUA
13 Diciembre 1955 Primer comisurotomia mitral (Dr. José Luis Arguello…Paciente:
Lucila viuda de Lorio). Cuarenta casos hasta Oct 1968.
12 Septiembre 1956 Primer Correcion de Ductus Arterioso Persitente (Dr. José Luis
Arguello). Dieciseis casos hasta Oct 1968
17 de Noviembre de 1965. Primer cirugía a corazón abierto en Centroamérica.
Implante de prótesis mitral (S.C.D.K). Dr. José Luis Arguello.
14.
15.
16.
17.
18. HISTORIA DE LA CARDIOLOGIA
NICARAGUENSE
• PERIODO DE
DESASTRES (1968-
1996)
19. BREVE HISTORIA DE LA CARDIOLOGIA EN NICARAGUA
• PERIODO DE DESASTRES (1968-1996)
36. HISTORIA DE LA CARDIOLOGIA
NICARAGUENSE
• PERIODO DE ORO
DEL CATETERISMO
CARDIACO (1996-
ACTUAL)
37. Un loco en 1929 se introduce una sonda urinaria en el atrio desde
una vena braquial, 30 años después gana el premio Nóbel.
Hoy es práctica cotidiana.
1956
WERNER FORSSMANN
38. SVER IVAN SELDINGER (1953)
Catheter replacement of the needle in percutaneous arteriography (a new technique).
Acta Radiologica, Stockholm, 1953, 39: 368-376.
39. SVER IVAN SELDINGER (1953)
Catheter replacement of the needle in percutaneous arteriography (a new technique).
Acta Radiologica, Stockholm, 1953, 39: 368-376.
INVENTO LA GUIA PARA INTRODUCIR
CATERES EN EL SISTEMA VASCULAR
Y EN MUCHAS CAVIDADES DEL CUERPO
NACE EL CATETERISMO COMO
PROCEDIMIENTO SEGURO
DEMUESTRA ABORDAJES INTRAVASCULARES
SIN ARTERIOTOMIA
40. Recanaliza por vía percutánea una arteria femoral superficial con
recuperación del pie
Nace la ANGIOPLASTIA TRANSLUMINAL PERCUTANEA
CHARLES DOTTER (1964)
54. BREVE HISTORIA DE LA CARDIOLOGIA EN NICARAGUA
• PERIODO DE ORO DEL CATETERISMO
CARDIACO (1996-2010)
A nivel de primer mundo en atención al corazón
*** Dos cardiólogos nicaragüenses acaban de regresar de España,
donde se especializaron en catéteres
*** En nuestro país hay un Laboratorio de Hemodinámica para dar
respuesta a accidentes cardiovasculares
Lunes 29 julio del 2002
62. BREVE HISTORIA DE LA CARDIOLOGIA EN NICARAGUA
• PERIODO DE ORO DEL CATETERISMO
CARDIACO (1996-2011)
CUATRO SALAS DE HEMODINAMICAS
SEIS HEMODINAMISTAS
ANGIOPLASTIA PRIMARIA
VALVULOPLASTIAS
INTERVENCIONISMO EXTRACARDIACO
BRIGADAS DE CARDIOLOGIA Y CIRUGIA
CARDIOVASCULAR
ECOCARDIOGRAFOS
PRUEBAS DE ESFUERZO
HOLTER RITMO, PRESION ARTERIAL
ECO TRANSESOFAGICO
ECO DOBUTAMINA
MESA BASCULANTE
UNIDADES CORONARIAS
TROMBOLISIS HOSPITALARIA
CIRUGIAS CARDIACAS
IMPLANTES DE MARCAPASOS, DESFIBRILADORES
ANGIOTOMOGRAFIA 64 CORTES
REHABILITACION CARDIOVASCULAR
ELECTROFISIOLOGIA
CARDIOLOGIA NUCLEAR
HEMODINAMICA
MOTOR DEL DESARROLLO
63.
64. BREVE HISTORIA DE LA CARDIOLOGIA EN NICARAGUA
Casos totales:
998 casos
HOSPITAL MILITAR A D BOLAÑOS
junio del 2006